Tuberculosis cutánea esporotricoide en la Amazonía peruana: reporte de caso / Sporotrichoid cutaneous tuberculosis in the peruvian amazon: case report

RESUMEN La tuberculosis cutánea es una presentación rara de la infección por Mycobacterium tuberculosis. Se presenta el caso de una mujer sin antecedentes médicos de importancia, con un tiempo de enfermedad de año y medio, caracterizado por lesiones tipo esporotricoide, con diseminación linfocutánea en miembro superior derecho, de evolución lentamente progresiva. Se realizó un estudio histopatológico encontrándose células gigantes tipo Langhans y escasa necrosis. El paciente recibió terapia de esquema sensible antituberculoso, con evolución favorable.

ABSTRACT Cutaneous tuberculosis is a rare presentation of Mycobacterium tuberculosis infection. We present the case of a woman without important medical history, with a disease period of one year and a half, characterized by sporotrichoid-like lesions, with lymphocutaneous dissemination in the right upper limb, and with slowly progressive evolution. The histopathological tests revealed Langhans type giant cells and scarce necrosis. The patient received therapy with a sensitive antituberculous scheme, and evolved favorably.

Cutaneous tuberculosis: epidemiological, clinical, diagnostic and therapeutic update

Abstract Tuberculosis is certainly one of the diseases considered to be ancient on planet Earth. The etiological agent of tuberculosis is Mycobacterium tuberculosis. This terrible bacterial infection still results in severe socioeconomic consequences to date, and its complete eradication represents a great challenge. It constitutes one of the most important public health problems in developing countries. According to the World Health Organization, this infection results in more than 4,000 deaths daily worldwide, with 10.4 million being affected annually and 1.5 million deaths from TB every year. With the emergence of the HIV/AIDS pandemic, the disease became the main cause of morbidity and mortality in patients infected with the human immunodeficiency virus. Cutaneous tuberculosis is a rare infection that represents 1% to 1.5% of extrapulmonary tuberculosis, whose etiological agents are Mycobacterium tuberculosis, Mycobacterium bovis, and the attenuated form of the bacillus Calmette-Guérin (BCG vaccine). Cutaneous tuberculosis can be exogenous; endogenous: caused by contiguity or autoinoculation and by hematogenous spread; induced by the Calmette-Guérin bacillus and manifest as a tuberculid. The diagnosis of the infection is carried out through the direct test, culture, histopathology, tuberculin skin test, polymerase chain reaction, interferon-gamma release assay, and genotyping. Drugs used comprise isoniazid, rifampicin, pyrazinamide and ethambutol.x

Eritema indurado de Bazin como una reactivación de una tuberculosis latente en una paciente con tratamiento biológico anti-factor de necrosis tumoral / Erythema induratum of Bazin as a reactivation of latent tuberculosis infection in a patient receiving anti-tumor necrosis factor treatment

Resumen El eritema indurado de Bazin es una tuberculosis cutánea rara, considerada una tuberculide o reacción de hipersensibilidad a Mycobacterium tuberculosis. El tratamiento con agentes biológicos es un factor de riesgo conocido para la reactivación de tuberculosis, especialmente en áreas de alta incidencia como Latinoamérica, por lo que existen protocolos de búsqueda y tratamiento antes del inicio de este tipo de terapias. Se presenta un caso clínico de eritema indurado de Bazin como reactivación de una infección tuberculosa latente en una paciente con artritis reumatoide que recibía tratamiento con golimumab.

Abstract Erythema induratum of Bazin is a rare form of cutaneous tuberculosis, considered as part of the spectrum of tuberculids or hipersensitivity reactions to Mycobacterium tuberculosis. Treatment with biologic agents is a known risk factor for tuberculosis reactivation, especially in areas of high incidence like Latin America, which is why screening and treatment protocols must be followed before these therapies are initiated. We present a case of erythema induratum of Bazin as a reactivation of latent tuberculosis infection in a patient with rheumatoid arthritis treated with golimumab.

Escrofuloderma: tuberculosis cutánea y pulmonar asociada a coinfección COVID-19: reporte de caso / Scrofuloderma, cutaneous and pulmonary tuberculosis associated with COVID-19: report of one case

Cutaneous tuberculosis represents 1-1.5% of extrapulmonary tuberculosis, including a variety of clinical conditions. Scrofuloderma and lupus vulgaris are the most common forms. We report a 49-year-old woman who sought medical attention through tele-dermatology concerning a cervical nodule associated with suppuration and cutaneous involvement. The diagnoses of scrofuloderma and pulmonary tuberculosis were confirmed, and during her evolution she presented a coinfection with SARS-CoV-2. The possible associations between tuberculosis and COVID-19 were reviewed.

Diagnosis of cutaneous tuberculosis (lymph node scrofuloderma) using the Xpert MTB/RIF® method

Abstract Cutaneous tuberculosis is a rare infection that is difficult to diagnose, because it shows less sensitivity and specificity in classic complementary exams when compared with the pulmonary form. The Xpert MTB/RIF® method offers an early diagnosis that identifies the DNA of Mycobacterium tuberculosis and the main mutations that give the bacterium resistance to rifampicin. The authors present a case of scrofuloderma whose diagnosis was quickly obtained through the secretion of a cervical lesion, allowing an early diagnosis and the initiation of appropriate treatment.

Disseminated tuberculosis associated with reactive arthritis of Poncet in an immunocompetent patient

Abstract Cutaneous tuberculosis is a rare extrapulmonary manifestation of tuberculosis which, like disseminated tuberculosis, commonly occurs in immunocompromised patients. Poncet reactive arthritis is a seronegative arthritis affecting patients with extrapulmonary tuberculosis, which is uncommon even in endemic countries. We report a previously healthy 23-year-old male patient with watery diarrhea associated with erythematous ulcers on the lower limbs and oligoarthritis of the hands. Histopathological examination of the skin showed epithelioid granulomatous process with palisade granulomas and central caseous necrosis. AFB screening by Ziehl-Neelsen staining showed intact bacilli, the culture was positive for Mycobacterium tuberculosis, and colonoscopy revealed multiple shallow ulcers. Disseminated tuberculosis associated with reactive Poncet arthritis was diagnosed, with an improvement of the clinical and skin condition after appropriate treatment.

Tubercúlide papulonecrótica: um relato de caso / Papulonecrotic tuberculids: a case report / Tubercúlide papulonecrótica: un informe de caso

As tubercúlides são reações de hipersensibilidade cutânea aos antígenos do Mycobacterium tuberculosis. Este é o caso de uma mulher de 45 anos que procurou a Unidade Básica de Saúde (UBS) com um quadro de eritema nodoso com mais de 10 anos de evolução, de etiologia desconhecida, e que evoluía como nódulos em pescoço e membros, que se tornavam úlceras necróticas, cicatrizavam e recidivavam periodicamente. Biópsias das lesões evidenciavam um processo inflamatório granulomatoso com extensa necrose, sugestivo de tuberculose, mas sem a presença do bacilo. Após anos sem tratamento adequado, finalmente levantou-se a hipótese de tubercúlide papulonecrótica. A paciente iniciou tratamento com o esquema básico (2RHZE/4RH) e dessensibilização vacinal, recebendo alta por cura.

Las tubercúlides son reacciones de hipersensibilidad cutánea a los antígenos del Mycobacterium tuberculosis. Este es el caso de una mujer de 45 años que buscó la Unidad Básica de Salud (UBS) con un cuadro de eritema nodoso con más de 10 años de evolución, de etiología desconocida, y que evolucionaba como nódulos en cuello y miembros, que se tornaban úlceras necróticas, cicatrizaban y recidivaban periódicamente. Las biopsias de las lesiones evidenciaban un proceso inflamatorio granulomatoso con una extensa necrosis, sugestiva de tuberculosis, pero sin la presencia del bacilo. Después de años sin tratamiento adecuado, finalmente se levantó la hipótesis de tubercúlide papulonecrótica. La paciente inició tratamiento con el esquema básico (2RHZE / 4RH) y desensibilización vacunal, recibiendo alta por curación

The tuberculids are cutaneous hypersensitivity reactions to Mycobacterium tuberculosis antigens. This is the case of a 45-year-old woman who sought the Basic Health Unit (BHU) with erythema nodosum with a 10-year evolution, of unknown etiology, that evolved as nodules in the neck and limbs, which became necrotic ulcers, cicatrized and recurred periodically. Biopsies of the lesions revealed a granulomatous inflammatory process with extensive necrosis, suggestive of tuberculosis, but without the presence of the bacillus. After years without adequate treatment, the hypothesis of papulonecrotic tuberculids finally arose. The patient started treatment with the basic regimen (2RHZE/4RH) and vaccine desensitization, receiving discharge by cure.

Scrofuloderma: a diagnostic challenge

Abstract: Cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis, comprising 1-2% of cases. Caused by Mycobacterium tuberculosis or related strains, it presents a wide range of clinical manifestations, mimicking other chronic dermatoses and leading to delayed diagnosis. A case of scrofuloderma is reported, whose diagnosis and treatment were only made six years after onset of the disease.

Seven cases of infant lichen scrofulosorum related to bacillus Calmette-Guérin vaccination / 中华皮肤科杂志

Objective To investigate the etiology,clinical manifestations,diagnosis and outcomes of lichen scrofulosorum (LS).Methods Clinical data collected from 7 infants with LS,who visited Department of Dermatology,Tianjin Children's Hospital between 2010 and 2018,were analyzed retrospectively,and the etiology,clinical manifestations,diagnosis,development and outcomes of LS were investigated.Results All the 7 infants developed LS after bacillus Calmette-Guérin (BCG)vaccination,and the clinical manifestations of LS were reddish or hazel papules mainly distributed on the trunk with small scales attached to the surface.No abnormal laboratory examination results were observed.Histopathological examination showed granuloma in the dennis.Without any treatment,all rashes of the 7 patients disappeared within 6 months,and no scar or hyperpigmentation remained.Conclusions Infant LS usually appears 2-3 months after BCG vaccination,clinically presents as papules mostly on the trunk,pathologically characterized as granuloma in the dermis,and can heal spontaneously.

Cutaneous tuberculosis / 中华皮肤科杂志

Cutaneous tuberculosis is an infectious disease caused by Mycobacterium tuberculosis complex.Its clinical manifestations vary with infection route,host immunity,etc.Traditional laboratory examinations,including acid-fast staining followed by direct microscopy,cultivation,histopathological examination and so on,still play important roles in the diagnosis and treatment of cutaneous tuberculosis.Development of a series of laboratory techniques represented by nucleic acid amplification tests provides significant support for accurate clinical diagnosis and treatment in recent years.This review summarizes advances in the etiology,pathogenesis,clinical manifestations,laboratory examinations and treatment of cutaneous tuberculosis.

Tuberculosis cutánea / Cutaneous tuberculosis

La tuberculosis cutánea (TC) es una afección infrecuente dentro de la tuberculosis extrapulmonar, siendo su clínica variada e inespecífica. Se presenta el caso de TC: Mujer de 48 años sin antecedentes mórbidos que consultó por lesión cutánea en pabellón auricular y piel circundante, de dos años de evolución, pruriginosa, con aumento de tamaño progresivo y supuración serosa ocasional, al examen se constató placa eritematosa anaranjada, de consistencia blanda. Reacción en Cadena de Polimerasa de biopsia evidenció infección por Mycobacterium tuberculosis, logrando remisión de la lesión con tratamiento antituberculoso establecido en las normas sanitarias de Chile. La TC es una entidad de difícil diagnóstico, incluso contando con cultivos. A causa del aumento de casos de tuberculosis por el incremento de factores inmunosupresores, y a su potencial agresividad sistémica, se recomienda un alto nivel de sospecha.

Cutaneous tuberculosis (CT) is an infrequent condition of extrapulmonary tuberculosis, with a varied and non-specific clinical morphologies. A case of CT is presented: 48-yearold woman with no morbid history, who consulted for a skin lesion in the auricular pavilion and surrounding area, of two years of evolution, pruritic, with increasing progressive size and occasional serous secreation. On physical examination, orange erythematous plaque with soft consistency was found. Polymerase Chain Reaction from biopsy, showed infection by Mycobacterium tuberculosis, achieving remission of the lesion with antituberculosis treatment established in Chilean sanitary regulations. CT is an entity difficult to diagnose even with the use of culture. A high level of suspicion is recommended because of the increase of cases of tuberculosis due to immunosuppressive factors and their potential systemic aggressiveness.

Cutaneous tuberculosis with nonreactive PPD skin test: a diagnostic challenge

The authors report a case of cutaneous tuberculosis in a 63-year-old female patient, who had an infiltrated, erythematous-ferruginous plaque of indurated aspect on her right leg and a nonreactive PPD skin test. Diagnosis was made by tissue culture and PCR of skin biopsy material. The treatment was performed with pyrazinamide, rifampicin, isoniazid and ethambutol, with good response.

Cutaneous tuberculosis: diagnosis, histopathology and treatment - Part II

The evolution in the knowledge of tuberculosis' physiopathology allowed not only a better understanding of the immunological factors involved in the disease process, but also the development of new laboratory tests, as well as the establishment of a histological classification that reflects the host's ability to contain the infectious agent. At the same time, the increasing bacilli resistance led to alterations in the basic tuberculosis treatment scheme in 2009. This article critically examines laboratory and histological investigations, treatment regimens for tuberculosis and possible adverse reactions to the most frequently used drugs.

Cutaneous tuberculosis: epidemiologic, etiopathogenic and clinical aspects - Part I

Cutaneous tuberculosis (CTB) is the result of a chronic infection by Mycobacterium tuberculosis, M. ovis and occasionally by the Calmette-Guerin bacillus. The clinical manifestations are variable and depend on the interaction of several factors including the site of infection and the host's immunity. This article revises the current knowledge about this disease's physiopathology and immunology as well as detailing the possible clinical presentations.

Perforating granuloma annulare mimicking papulonecrotic tuberculid / Granuloma anular perfurante simulando tuberculide papulo-necrotica

A case is reported of a patient presenting lymph node tuberculosis and cutaneous lesions resembling papulonecrotic tuberculid, but histologically compatible with perforating granuloma annulare and which responded satisfactorily to antituberculous therapy. This is probably one of the first reports of the association of perforating granuloma annulare and tuberculosis, and it is important therefore to highlight the relevance of this disorder in the differential diagnosis of papulonecrotic tuberculid and to raise the hypothesis that this entity should also be considered to be a variant of tuberculid.

Os autores relatam o caso de uma paciente com tuberculose ganglionar e lesões cutâneas clinicamente sugestivas de tubercúlide pápulo-necrótica, porém com histopatologia compatível com granuloma anular perfurante, e que apresentaram melhora após tratamento para a tuberculose. Trata-se, possivelmente, de um dos primeiros relatos da associação de granuloma anular perfurante com tuberculose, salientando a importância desta entidade no diagnóstico diferencial da tubercúlide pápulo-necrótica e levantando a possibilidade da mesma ser considerada, também, uma variante de tubercúlide.

Expression of Toll-like receptors 2, 4 and 9 in cutaneous tuberculosis lesions / 中华皮肤科杂志

Objective To observe the expression of Toll-like receptors (TLRs) 2,4 and 9 in lesions of lupus vulgaris and tuberculosis verrucosa cutis,and to evaluate the possible roles of these receptors in the pathogenesis of cutaneous tuberculosis.Methods Skin specimens were obtained from the lesions of 18 patients with clinically and pathologically diagnosed lupus vulgaris or tuberculosis verrucosa cutis,15 patients with plaque-type psoriasis (positive control),and from perilesional normal skin of 10 patients with pigmented nevi (negative control).Immunohistochemistry was used to detect the expression of TLRs 2,4 and 9 in these specimens,and the expression intensity was expressed as absorbence values.Data were analysed by using the SPSS 13.0 software,and t test was conducted to assess the differences between the three groups of specimens.Results TLR-2 was observed mainly in the middle and upper layer of epidermis in lesions of cutaneous tuberculosis and psoriasis,and in the whole epidermis except the basal layer in normal skin,with no significant difference in the expression intensity between the three groups of specimens (0.25 ± 0.04 vs.0.25 ± 0.05 vs.0.28 ± 0.03,P ＞ 0.05).TLR-4 was weakly expressed in cutaneous tuberculosis lesions,absent or slightly expressed in normal skin and psoriatic lesions,and the expression level of TLR-4 was significantly higher in cutaneous tuberculosis lesions than in normal skin and psoriatic lesions (0.16 ± 0.07 vs.0.07 ± 0.09 and 0.02± 0.05,t =2.58,6.24,P ＜ 0.01 and 0.05).TLR-9 was expressed in the whole epidermal layer,including appendages and vascular walls,of cutaneous tuberculosis and normal skin,with a significant increase in cutaneous tuberculosis than in the normal skin (0.25 ± 0.05 vs.0.19 ± 0.05,t =2.88,P＜ 0.05).Conclusions TLRs 2,4 and 9 are all expressed in cutaneous tuberculosis losious,and the expression intensity of TLR-4 and TLR-9 is higher in cutaneous tuberculosis lesions than in normal skin,hinting that TLR-4 and TLR-9 play a certain role in the immune response of cutaneous tuberculosis.

Erythema induratum of Bazin associated with Addison's disease: first description / Eritema indurado de Bazin associado à doença de Addison: primeira descrição

CONTEXT: Erythema induratum of Bazin (EIB) is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. CASE REPORT: We report the case of a woman with EIB who developed Addison's disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. The diagnosis was obtained through the clinical picture, positive tuberculin test and positive BCG (bacillus Calmette-Guérin) test on the histological sample. Anti-tuberculosis drugs and glucocorticoid replacement led to disappearance of the signs and symptoms. CONCLUSIONS: This is the first description of an association between EIB and Addison's disease. It should be borne in mind that tuberculosis is an important etiological factor for Addison's disease.

CONTEXTO: O eritema indurado de Bazin (EIB) é considerado uma reação tuberculoide e consiste de nódulos dolorosos recorrentes. O diagnóstico diferencial inclui doenças como vasculite nodular, perniose, poliarterite nodosa e eritema nodoso. RELATO DE CASO: Nós reportamos o caso de uma mulher com EIB que desenvolveu doença de Addison durante tratamento com drogas tuberculostáticas e com boa resposta com reposição de glicocorticoide. O diagnóstico foi realizado pela apresentação clínica, teste tuberculínico positivo e positividade para BCG (bacilo Calmette-Guérin) no espécime histológico. A reposição de glicocorticoides e drogas tuberculostáticas levou ao desaparecimento dos sinais e sintomas. CONCLUSÕES: Este é o primeiro caso reportando a associação entre EIB e doença de Addison. Tuberculose é um importante agente etiológico da doença de Addison.

Recurrent nodules in the calves: A sign of tuberculosis / Recurrent nodules in the calves: A sign of tuberculosis

Aims: To describe a case of erythema induratum of Bazin, classified as a tuberculid, or skin lesion with similar histological features to true cutaneous tuberculosis, in which the relation with Mycobacterium tuberculosis cannot be easily demonstrated.Case Description: A 60-year-old woman presented with recurrent multiple nodules in the legs. Skin examination revealed violaceous painless nodules, some of them ulcerated, with a serous fluid, located on both legs in an asymmetric way, predominantly in the calves. Lesions disappeared spontaneously for brief periods. Skin biopsies revealed septal and lobular panniculitis with epithelioid granulomata and vascular necrosis. Tuberculin skin test was positive. Culture of the cutaneous lesions and polymerase chain reaction to Mycobacterium tuberculosis were negative, but mediastinal lymph nodes collected through mediastinoscopy were cultivated and positive to Mycobacterium tuberculosis. Therapy with isoniazid, rifampicin, pyrazinamide and ethambutol were administered. After two months under therapy the skin lesions healed. The clinical and histopathological features and the strong positive tuberculin skin test have strongly suggested the diagnosis of erythema induratum of Bazin. Positive culture for Mycobacterium tuberculosis and the remission of the lesions with antituberculosis therapy confirmed the diagnosis.Conclusions: Clinicians must be aware of the differential diagnosis of recurrent skin lesions, including the erythema induratum of Bazin. In this case, association with tuberculosis was confirmed by positive culture of mediastinal lymph nodes for Mycobacterium tuberculosis and remission of the lesions with antituberculosis therapy.

Objetivos: descrever um caso de eritema induratum de Bazin, classificado como tubercúlide, lesão cutânea com características histológicas semelhantes à tuberculose cutânea, mas na qual a relação entre o Mycobacterium tuberculosis não é facilmente demonstrada.Descrição do Caso: uma mulher de 60 anos de idade apresentou-se com múltiplos nódulos recorrentes nos membros inferiores. O exame da pele revelou nódulos indolores, violáceos, alguns deles ulcerados, com um líquido seroso, localizados em ambas as pernas, de forma assimétrica e com predomínio nas panturrilhas. As lesões apresentavam um aparecimento paroxístico, com remissão espontânea por breves períodos. Foi realizada biópsia cutânea que revelou paniculite septal e lobular com granulomas epitelióides e necrose vascular. O teste tuberculínico foi positivo. A cultura das lesões cutâneas e a reação em cadeia da polimerase para Mycobacterium tuberculosis foram negativos, mas foi realizada biópsia de linfonodos por mediastinoscopia, cuja cultura foi positiva para Mycobacterium tuberculosis. Foi iniciada terapêutica específica com isoniazida, rifampicina, pirazinamida e etambutol. Após dois meses de tratamento houve remissão das lesões. As características clínicas e histopatológicas e o teste tuberculínico fortemente positivo sugeriram o diagnóstico de eritema indurado de Bazin, sendo este confirmado pela cultura de linfonodos positiva para Mycobacterium tuberculosis e pela remissão das lesões com a terapêutica antituberculose.Conclusões: o clínico precisa estar atento para o diagnóstico diferencial de lesões cutâneas recorrentes, incluindo neste o eritema induratum de Bazin. Neste caso, a associação com a tuberculose ficou confirmada pela cultura dos linfonodos mediastinais positiva para Mycobacterium tuberculosis e remissão das lesões com a terapêutica antituberculose.

Cutaneous tuberculosis and squamous-cell carcinoma / Tuberculose cutânea e carcinoma de células escamosas

The incidence of all forms of cutaneous tuberculosis, including lupus vulgaris (the most common form) decreased progressively in developed countries during the twentieth century, this change being attributed to improved living standards and specific therapy. Despite the decrease in cutaneous tuberculosis, some cases are still found and correct diagnosis and management are fundamental, both for the patients and for public health. Long lasting, misdiagnosed or untreated cutaneous tuberculosis may lead to different forms of cancer. This case report involves a 74-year old male farmer with lupus vulgaris on his face. During anti-tuberculosis treatment he developed a tumor on his forehead, which was histologically confirmed as a squamous cell carcinoma.

A incidência de todas as formas de tuberculose cutânea, incluindo o lúpus vulgar (a forma mais comum) diminuiu progressivamente nos países desenvolvidos durante o século XX e esta mudança foi atribuída a melhores condições de vida e uso de terapia específica. Apesar da diminuição da TBC cutânea, alguns casos ainda são detectados hoje em dia e o diagnóstico acurado e o tratamento apropriado são fundamentais para os doentes e a saúde pública. A TBC cutânea quando prolongada, diagnosticada erroneamente ou não tratada pode levar a diferentes neoplasias. Este é o relato de um caso de lúpus vulgar na pele do rosto de uma paciente do sexo masculino, agricultor, de 74 anos de idade. Durante a terapia antituberculosa ele desenvolveu um tumor na pele da testa, histologicamente confirmado como carcinoma de células escamosas.

Cutaneous tuberculosis in Penang: A 12-year retrospective study

Background Cutaneous tuberculosis (TB) is a form of extrapulmonary tuberculosis. Diagnosis of cutaneous TB is often difficult because of the diverse clinical presentations. The positive yields from cultures are often low. To describe the demographic, clinical, histopathological and bacteriological aspects of cutaneous TB. Materials and Methods This retrospective review looked at cases of cutaneous tuberculosis treated at the Respiratory and Dermatology unit, Penang Hospital from 1996 to 2007. Data were analysed with SPSS 13.0 version. Results A total of 23 cases of cutaneous tuberculosis were reviewed. The male to female ratio was 2.3 to 1. The mean age was 37.7 ± 20.7 years. There were 10 Malays, 9 Chinese, 2 Indians and 2 Indonesian. The types of cutaneous tuberculosis observed were lupus vulgaris (47.8%), tuberculides (17.5%), tuberculosis verrucosa cutis (13.0%), scrofuloderma (13.0%) and primary inoculation TB (8.7%). 43.5% of patients had systemic involvement. Mantoux tests were positive in 85.0% of cases. Skin biopsies were performed in 91.3% of patients and 71.4% of them showed classical histopathologic findings suggestive of tuberculosis. Mycobacterium tuberculosis was isolated in the culture from 28.6% of patients. Localized diseases were found more often in BCG-vaccinated individuals. Regional lymphadenopathy was noted more often in patients with disseminated disease. No correlation was found between Mantoux reactivity and the extent of disease. Conclusion Lupus vulgaris was the commonest form of cutaneous tuberculosis. Cultures were positive in only a small proportion of patients. Almost half of our patients had systemic involvement. The presence of regional lymphadenopathy often indicates disseminated disease. Patients without BCG vaccination were at higher risk of disease dissemination.